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      Humeral shaft fractures

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          Abstract

          • Humeral shaft fractures are relatively common, representing approximately 1% to 5% of all fractures.

          • Conservative management is the treatment of choice for most humeral shaft fractures and offers functional results and union rates that are not inferior to surgical management.

          • Age and oblique fractures of the proximal third are risk factors for nonunion. Surgical indication threshold should be lower in patients older than 55 years presenting with this type of fracture.

          • Functional outcomes and union rates after plating and intramedullary nailing are comparable, but the likelihood of shoulder complications is higher with intramedullary nailing.

          • There is no advantage to early exploration of the radial nerve even in secondary radial nerve palsy.

          Cite this article: EFORT Open Rev 2021;6:24-34. DOI: 10.1302/2058-5241.6.200033

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          Epidemiology of adult fractures: A review.

          Charles Court-Brown, Ben Caesar (2006)
          The epidemiology of adult fractures is changing quickly. An analysis of 5953 fractures reviewed in a single orthopaedic trauma unit in 2000 showed that there are eight different fracture distribution curves into which all fractures can be placed. Only two fracture curves involve predominantly young patients; the other six show an increased incidence of fractures in older patients. It is popularly assumed that osteoporotic fractures are mainly seen in the thoracolumbar spine, proximal femur, proximal humerus and distal radius, but analysis of the data indicates that 14 different fractures should now be considered to be potentially osteoporotic. About 30% of fractures in men, 66% of fractures in women and 70% of inpatient fractures are potentially osteoporotic.
          Article 0 comments Cited 775 times – based on 0 reviews     Review now
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            Fracture and Dislocation Classification Compendium—2018

            EG Meinberg, J Agel, CS Roberts … (2018)
            Article 0 comments Cited 536 times – based on 0 reviews     Review now
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              Radial nerve palsy associated with fractures of the shaft of the humerus: a systematic review.

              M Grotz, P. Harwood, Y. Shao … (2005)
              The management of radial nerve palsy associated with fractures of the shaft of the humerus has been disputed for several decades. This study has systematically reviewed the published evidence and developed an algorithm to guide management. We searched web-based databases for studies published in the past 40 years and identified further pages through manual searches of the bibliography in papers identified electronically. Of 391 papers identified initially, encompassing a total of 1045 patients with radial nerve palsy, 35 papers met all our criteria for eligibility. Meticulous extraction of the data was carried out according to a preset protocol. The overall prevalence of radial nerve palsy after fracture of the shaft of the humerus in 21 papers was 11.8% (532 palsies in 4517 fractures). Fractures of the middle and middle-distal parts of the shaft had a significantly higher association with radial nerve palsy than those in other parts. Transverse and spiral fractures were more likely to be associated with radial nerve palsy than oblique and comminuted patterns of fracture (p < 0.001). The overall rate of recovery was 88.1% (921 of 1045), with spontaneous recovery reaching 70.7% (411 of 581) in patients treated conservatively. There was no significant difference in the final results when comparing groups which were initially managed expectantly with those explored early, suggesting that the initial expectant treatment did not affect the extent of nerve recovery adversely and would avoid many unnecessary operations. A treatment algorithm for the management of radial nerve palsy associated with fracture of the shaft of the humerus is recommended by the authors.
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                Author and article information

                Journal
                Journal ID (nlm-ta): EFORT Open Rev
                Journal ID (iso-abbrev): EFORT Open Rev
                Title: EFORT Open Reviews
                Publisher: British Editorial Society of Bone and Joint Surgery
                ISSN (Electronic): 2058-5241
                Publication date Collection: January 2021
                Publication date (Electronic): 4 January 2021
                Volume: 6
                Issue: 1
                Pages: 24-34
                Affiliations
                [1 ]Department of Orthopaedics and Traumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
                [2 ]Division of Orthopedic Surgery, McGill University, Montreal, Canada
                Author notes
                [*]Frédéric Vauclair, Centre Hospitalier Universitaire Vaudois, Département de l’appareil locomoteur, Service d’orthopédie et de traumatologie, Rue du Bugnon 46, BH 10-240, CH-1011 Lausanne, Switzerland. Email : frederic.vauclair@ 123456chuv.ch
                Author information
                https://orcid.org/0000-0002-2931-2150
                Article
                Publisher ID: 10.1302_2058-5241.6.200033
                DOI: 10.1302/2058-5241.6.200033
                PMC ID: 7845564
                PubMed ID: 33532084
                SO-VID: 2c7bbd84-8f5e-4798-ab7d-bfe0762d9b59
                Copyright © © 2021 The author(s)
                License:

                This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

                History
                Categories
                Subject: Shoulder & Elbow
                Subject: 12
                Subject: Fracture
                Subject: Humeral Shaft
                Subject: Treatment

                Keywords: fracture,humeral shaft,treatment
                Data availability:
                Keywords: fracture, humeral shaft, treatment

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